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FO-GL-HAL-WPS-500

HALLIBURTON Certificate of Service Certificate of Service - Form

Reason for Certificate of Service (COS) Annual Recertification Other

Certificate number: 12775226-0323


Date: 3/3/2023 Expiration Date: 1-Mar-24

COC/COS History Certificate Number Issue Date


Current Certificate of Conformance (COC) 12775226-0919 4-Sep-19
Previous Certificate of Service (COS) 12775226-0323 3-Mar-23

Original Equipment History


Equipment Type/Description LUBRICATOR ASSY 4.06" E12 L/W 10K H2S 10
Original Equipment Manufacturer Name NOV ASEP ELMAR
Original Date of Manufacturing 12/10/2013
OEM Part Number L-9701971846L100
OEM Serial Number AEUS13M048
Halliburton Equipment Number 12775226

Applicable Equipment Testing, Inspections and Equipment Rating


Pressure Test Pressure Functional Visual
Current High Duration Low Test Duration Pressure Recorder Serial Calibration Test Inspection
Certification (psi) (min) (psi) (min) (type) Number Date (Yes/No) (Yes/No)
15000 3
COC 300 3 Digital 300133699 April 30, 2019 YES YES
15000 15

10000 3
COS 300 3 Digital 399108647 May 2, 2022 YES YES
10000 15

Well Head Pressure Control Maintenance for details related to pressure testing and
Reference: WM-GL-HAL-WPS-1705
inspection of WPCE

Conformation:
This Certificate Of Service confirms that the equipment / parts listed on this certificate have been, inspected and maintained in accordance
with the OEM engineering specifications and complies with API6A Specification for Wellhead and Christmas Tree Equipment and NACE
Standard MR-01-75 / ISO 15156

Replaced Parts List


Part Description Part No: Serial No: Material Cert No:
N/A N/A N/A N/A
O-RING,348 90 DURO NITRILE 98954
BACK UP RING 348, ELMAR L-873720 98976

WPCE Maintenance Complete: WPCE maintenance and the


Documentation / Certification Pack has been completed, as per WM- QA QC Review Complete: Certification Pack has been verified.
GL-HAL-WPS-1705
Name: Daniel Alves Guimarães Name: Renato Couto de Souza
Employee #: 524698 Employee #: 512102
Renato Assinado de forma
Date: 3-Mar-23 Date: 3-Mar-23 Couto de
digital por Renato
Couto de Souza
Dados: 2023.03.08
Souza 09:29:13 -03'00'

Digitally signed by
Daniel Alves Daniel Alves
Guimaraes
Guimaraes Date: 2023.03.08
Owner: Technical Services 10:48:03 -03'00'
Revision I
Approver: Technical Services Mgr Revised by: Richard Housden Page 1 of 2
FO-GL-HAL-WPS-500
HALLIBURTON Certificate of Service Certificate of Service - Form

Name: Renato Couto de Souza


Employee #: 512102
Date: 3-Mar-23
Renato Assinado de
forma digital por

Couto de Souza
Renato Couto de

Souza Dados: 2023.03.08


09:29:31 -03'00'
Owner: Technical Services Revision I
Approver: Technical Services Mgr Revised by: Richard Housden Page 2 of 2

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